Fertility shock

It's a common misconception that infertility is suffered by women who have saved childbearing for the final act of their professional career.

Unfortunately, nothing could be further from the truth. I should know - I'm one statistic among millions. According to the Infertility Awareness Association of Canada, one in six Canadian couples of childbearing age suffer from it and meet with little or no public support.

And now, as of last month, Women's College Hospital has quietly cut its rare Infertility Support and Education Program, which quite literally performed emotional resuscitation on me.

To say my sanity was precarious would be a mild way of describing it. By the fifth year of "trying," enduring multiple procedures and miscarriages, I had closed shop creatively and was a brittle shell of my former self.

I stopped painting, drawing and exhibiting. I stopped writing. I dragged myself to work in the morning and attempted the Oscar performance of my life teaching male teenagers in a custody program (i.e., jail) that reading was a valid pastime.

The Women's College program was run by Jan Silverman, who counselled thousands of women over the past 20 years and is a past chair of the Ontario Women's Health Network and the recipient of the Canadian Fertility and Andrology Society's Care and Life Award. Her real passion emerged in the three support groups she ran in the evenings in the emptied and darkened offices of Women's College's Bay Centre for Birth Control: an infertility group; one for women with endometriosis; and one for single parents who wish to start families either through adoption or reproductive technologies.

Novelist William Styron wrote about darkness being made visible. Those groups did that. Sometimes you just had to drag along a witness for backup. Sometimes people brought their parents or a sibling or a best friend.

I remember my first meeting with Silverman - my first support group ever. It was during a January blizzard. Over 40 people showed up, dripping with snow. In the centre of the circle of chairs, on a disproportionately small plastic coffee table, sat a pathetic box of Kleenex. Someone was already using it. It was a woman in her late 20s enduring her sixth miscarriage.

"What's going to be lost with my program is women's ability to self-refer and get immediate support [rather than needing a doctor's referral] without wait times," says Silverman. "Often, to get infertility support elsewhere, you need to be pathologized."

Currently, there are very few fertility support groups in Toronto. For this reason, Silverman is continuing to run the groups without pay out of a space provided by the hospital.

Says Dianne Allen of the Infertility Network, "I am absolutely shocked by this announcement. This was the only funded position in the city. You have to pay big bucks ($130 to $175 an hour) for any other infertility counsellor. How can anyone afford that on top of fertility treatments?''

Jodi Salem, the hospital's director of strategic communications, refused to be interviewed, saying, "I cannot expand beyond the form letter" the hospital sent out upon the program's closure. The letter refers to alternative groups offered by the Infertility Network and the Infertility Awareness Association of Canada, but the latter's website refers clients to the now-defunct Women's College groups, and the former has recently closed down its local support group.

The letter also lists other hospital infertility support services. But I know their limitations because I was routed to them first. First, I self-referred to the Brief Psychotherapy Centre for Women only to discover that I alone (not my husband) had to resolve my years-long struggle within six short sessions.

Unsatisfied, I was then shunted to the Reproductive Life Stages Program in Women's College's mental health department. To get there, I needed a clinical diagnosis and a doctor's referral. There's an extensive wait time, however, and a psychiatric framework in play.

Silverman's style was full-out support; she visited clients in the fertility clinic before procedures and knew the side effects of drugs and their exorbitant cost. She attended conferences on the latest technologies and treatments, and advocated in support of extending OHIP funding for in vitro fertilization, as the Quebec government has done.

Ontario will only pay for IVF procedures for women with bilateral blocked fallopian tubes. In 2009, the Dalton McGuinty government commissioned an expert panel on infertility and adoption (Silverman was on it), whose report, Raising Expectations, recommended that the province pay for up to three full cycles of IVF, as Quebec does, partly as a money-saving move. It would offset $400 to $500 million over the next 10 years by reducing multiple births, which are often the consequence of couples insisting on more than one embryo transfer at a time, since the procedure is costly and there's always the chance that one alone will not implant.

I'm now the happy mom of twins. My journey could easily fill a book - maybe two. For the sake of others taking the first steps on a long, difficult road, I'm becoming an advocate for women in need of support during infertility. What an outrage that our city's only woman-centred hospital yanked a service that has helped so many.